Continuing Healthcare

What is Continuing Healthcare?

NHS Continuing Healthcare is the name given to a package of care which is arranged and funded solely by the NHS for individuals outside of hospital who have ongoing health care needs.You can receive NHS Continuing Healthcare in any setting, including your own home or in a care home. NHS Continuing Healthcare is free, unlike support provided by local authorities for which a financial charge may be made depending on your income and savings.A review of NHS Continuing Healthcare is undertaken by a multidisciplinary team at three months and then yearly, and a recommendation is made by the multidisciplinary team as to whether a patient meets the criteria for NHS Continuing Healthcare.

Anyone assessed as requiring a certain level of care need, can get NHS continuing healthcare. It is not dependent on a particular disease, diagnosis or condition, or on who provides the care or where that care is provided. The circumstances can include:

Older people with chronic illness or disabilities

Older people suffering from mental illness or dementia

People suffering from mental illness

Physically disabled adults

People with learning disabilities

People who are terminally ill

If your overall care needs show that your primary need is a health one, you should qualify for continuing healthcare. The primary health needs should be assessed by looking at all your care needs and relating them to four key indicators.

Nature – the type of condition or treatment required (quality and quantity)

Complexity – symptoms that interact, therefore difficult to manage or control

Intensity – one or more health needs, so severe they require regular intervention

Unpredictability- unexpected changes in condition that are difficult to manage and present a risk to you or others.

Personal Health Budgets

Some people who are eligible for CHC choose to have a personal health budget so they can organise and manage their care themselves. Read more about PHBs here

If you do not qualify for NHS continuing healthcare then you may have to pay for some or all of your care, although the NHS will still provide for your medical needs. You may have to take a local authority means test to decide how much you should pay towards your personal care and accommodation if you are in a care home.

How do I appeal against a decision?

If following assessment for NHS Continuing Healthcare you remain unsatisfied with the outcome you can contact the CHC team to contest the decision.